The choice of chemotherapy is based on the stage, cell type and molecular characteristics of the tumor. Depending on the molecular features of the tumor, i.e., presence of driver mutations or a high concentration of cells expressing programmed death ligand I mutations (PD-L1), therapy may consist of immunotherapy or in the absence of these or with low concentrations of PD-L1, or where the mutation status is unknown, treatment is with chemotherapy.
Commonly used chemotherapy drugs for lung cancer are cisplatin plus gemcitabine, pemetrexed, and erlotinib. The monoclonal antibodies, bevacizumab or pembrolizumab may be added to therapy.
With chemotherapy, you should expect some side effects. The severity of the side effects is dependent on how aggressively you are treated, i.e., the dose and frequency of the chemotherapy drugs.
You will probably notice some fatigue, and you may develop nausea, possibly vomiting (these can be ameliorated by anti-nausea medications); diarrhea may also occur. There may be skin rashes and loss of hair. You may develop some tingling and loss of sensation in the feet and hands, and there is a risk of some hearing loss. These drugs reduce the white blood cells in your blood as well some clotting factors and there is a possibility of kidney and liver injury. With cessation of therapy these side effects usually disappear. Your physician will adjust the dose depending on your age and other comorbidities, and should carefully monitor you for these side effects and adjust the dose accordingly.